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Randomized Controlled Trial
. 2013;28(10):1121-34.
doi: 10.1080/08870446.2013.789875. Epub 2013 Apr 22.

Step-down approach to behavioural weight loss treatment: a pilot of a randomised clinical trial

Robert A Carels  1 , Debra A Hoffmann, Nova Hinman, Jacob M Burmeister, Afton Koball, Lisham Ashrafioun, Marissa W Oehlhof, Erin Bannon, Michelle Leroy, Lynn Darby
Affiliations
Randomized Controlled Trial

Step-down approach to behavioural weight loss treatment: a pilot of a randomised clinical trial

Robert A Carels et al. Psychol Health. 2013.

Abstract

Background: In a stepped-down approach, patients begin with a more intensive treatment and are stepped down to a less intensive treatment based on achieving treatment goals. This study compared a standard behavioural weight loss programme (BWLP) to a stepped-down approach to treatment.

Methods: Fifty-two overweight/obese adults (Age: M = 47 years, SD = 13.5; female = 67%) participated in an 18-week BWLP. Half of them were randomly assigned to be stepped down from weekly group meetings based on completion of weight loss goals (3%) every 6 weeks, while the other half remained in their groups regardless of weight loss.

Results: There was a significant difference favouring the BWLP in the proportion of participants who met or exceeded their 3% weight loss goal during the first six weeks. While not statistically significant by the end of treatment, the BWLP participants lost nearly 3% more body weight than stepped-down participants (SC = 4.9% vs. BWLP = 7.8%; p = .10). Greater self-monitoring was associated with increased likelihood of stepped-care eligibility and higher percent weight loss at the end of treatment (p < .01).

Conclusion: There was little evidence to support the efficacy of the stepped-down approach for behavioural weight loss treatment employed in this investigation.

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Figure 1
Participant flow diagram.
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